Dr. Esther K. Choo is Assistant Professor in the Department of Emergency Medicine at Warren Alpert Medical School of Brown University. Her long-term goal is to become an independent investigator with a focus on developing effective interventions for high-risk women with substance use disorders. The overall aim of Dr. Choo's proposal is to target co-occurring problems of substance use and intimate partner violence (IPV) using a computer-based intervention, B-SAFER (Brief intervention for Substance use and partner Abuse for Females in the Emergency Room). This K23 Mentored Patient-Oriented Career Development Award proposal is in keeping with NIDA's mission, with great potential to significantly improve treatment of drug abuse through an intervention that could be rapidly and effectively disseminated to other emergency departments (EDs) and to other clinical settings. Substance use and IPV have a close, bidirectional relationship, and the coexisting disorders place women at high risk for poor mental and physical health outcomes. The ED presents a great opportunity to intervene in this population, as coexisting problems are highly prevalent, while adequate assessment, intervention and referrals are not routinely available. Further, no resource is available in the ED to address related problems of substance use and IPV in an integrated manner. As a computer-based intervention, B-SAFER has great potential as a feasible and acceptable ED resource. The research project has two phases. The Development Phase will use focus groups to inform and refine the development of the computer-based intervention, and will conclude with a small open trial. The Testing Phase will be a pilot RCT of the intervention in a high-volume urban ED, examining primary outcomes of substance use and utilization of relationship safety resources. In completing this research and associated training activities, Dr. Choo plans to gain the skills, knowledge and experience needed to become a national leader in research on technology-based interventions for women with substance use. Her goals are to gain skills in: 1) using qualitative health research methodology to inform the development of interventions;2) developing and testing computerized interventions for substance use and IPV;3) conducting clinical trials of substance use and IPV interventions;4) analyzing longitudinal data;and 5) addressing the ethical issues related to research using computerized interventions for individuals with substance use and victimization. PUBLIC HEALTH RELEVANCE: This project seeks to address the health care of women with coexisting substance use and IPV presenting to the ED setting, a population at high risk and with high health care needs and yet few available resources. The results of this research could contribute to national models of care in ED settings and will provide opportunities for Dr. Choo to develop, test and disseminate similar interventions for women with substance use and IPV in other clinical and community settings.